In this two-part series on arrhythmias occurring above the semilunar valve, we discuss the relevant underlying anatomy and the technique for mapping and ablation above the aortic and pulmonic valve. In part I, we focused on ventricular arrhythmias, and in this paper (part II), we discuss the anatomy and present knowledge of the substrate mapped and ablated above the aortic valve for atrial tachycardia in certain unusual accessory pathways. The background anatomy of the aortic valve has been discussed in part I of this series, to which the reader is referred. Here we discuss the detailed anatomy of the aortic cusps relevant for atrial tachycardia and atrioventricular bypass tracts. Representative cases of these supravalvar arrhythmias are presented, and an approach for safe and effective ablation above the aortic valve to eliminate atrial tachycardia and bypass tracts in this location is then outlined.
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Published online: May 06, 2008
© 2008 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.